The Research Case For Using Psilocybin To Treat End-Of-Life Anxiety
“The last thing I want is to be terrified and scared and anxious, especially when I pass,” Erinn Baldeschwiler, a 48-year-old with terminal breast cancer, recently told Time Magazine. As Baldeschwiler’s fears underscore, a terminal cancer diagnosis is devastating, often leaving patients consumed by chronic depression and anxiety. For Baldeschwiler, like a growing number of end-stage cancer patients, psilocybin-assisted treatment provided significant relief. And the clinical trials that these patients participated in are generating a backbone of promising research.
A landmark study from UCLA Medical Center found that psilocybin provides relief for “the profound existential anxiety and despair that often accompany advanced-stage cancers[.]” Pam Sakuda, one of the end-stage participants in the study, outlived her doctor’s original life expectancy by four years, which was a blessing that came with a heavy toll in the form of persistent anxiety over exactly when the cancer would finally take her life. Sakuda’s husband told the the New York Times that “it got to the point where we couldn’t make even the most mundane plans, because we didn’t know if Pam would still be alive at that time—a concert, dinner with friends; would she still be here for that?” Pam’s participation in the UCLA study had a profound impact on her life– not just a reduction in anxiety, but as her husband put it, a “glowing from the inside out.” Her experience embodies the study’s central finding—participants experienced a “sustained reduction in anxiety that reached [statistical] significance at the 1- and 3-month points after treatment”.
A more recent New York University medical school study of terminal cancer patients suffering from anxiety and depression similarly found that psilocybin-assisted therapy produced “rapid and sustained improvements in anxiety and depression”. The researchers also found that the treatment led to “decreased cancer-related demoralization and hopelessness” and an overall “increased quality of life.” The results are particularly striking given that, as the researchers explained, “there are currently no [FDA approved drugs] or evidence-based combined [drug and talk therapy options] to treat this particular type of distress and unmet clinical need in cancer patients.”
A follow-up on the NYU study documented the long-lasting effects of the initial psilocybin-assisted treatment. The same NYU researchers checked-in with the subset of participants in their original study who were still alive almost five years later. Remarkably, between 60 and 80% of the participants sustained at a clinically significant level the original reductions in anxiety, depression, hopelessness, and demoralization. The vast majority of participants also attributed “positive life changes” to the psilocybin treatment and a number of them “rated it among the most personally meaningful and spiritually significant experiences” of their lives. Dr. Stephen Ross, a lead researcher on the studies, concluded that psilocybin “could profoundly transform [the] care of patients with cancer[.]”
“The growing evidence from rigorous research [on psilocybin] has caused many physicians, like me, to reassess.” Writing for the Washington Post, Dr. Manish Agrawal, an oncologist and co-director of clinical research at Maryland’s Aquilino Cancer Center, described how his once-skeptical view of psilocybin-assisted treatment shifted after witnessing its potential first-hand. “I have never witnessed the sort of dramatic response to any medical intervention as I have with some patients through psychedelic-assisted therapy.” Agrawal believes that once the FDA approves psilocybin treatment for depression and anxiety, it could become part of the standard care protocol for cancer patients in the same way that chemotherapy and radiation treatments are today. “The deep distress and the dark feelings [patients] experience after being diagnosed with cancer are normal and deserve as much attention as the physical effects of their cancer…[they] should not have to go somewhere outside the cancer treatment center to get that help.”
